Nutrition Cluster alarmed Milk Code breached in quake relief donations

CEBU, Philippines - San Isidro, Bohol - Rays of the afternoon sun slit through the evacuation tents then to a hammock where a baby was asleep. Barely three months old, the earthquake caught a 19-year-old mother and her baby in the vortex of disaster. Nutrition health workers peered at the baby but feeling that she was watched, the baby whimpered. The teenage mom scooped her baby from the hammock and held the baby to her breast for feeding. The municipality of San Isidro was among the hardest hit areas during the October 15 quake in Bohol.

Instead of promoting breastfeeding during emergencies, the Milk Code may have been seriously breached after nutrition action officers and health workers based in Bohol humbly owned up that they had not regulated the acceptance, distribution and consumption of infant formulas and milk formulas as part of the relief goods for quake victims. In a nutrition cluster consultative meeting held last October 30 in Tagbilaran City, nutrition workers and officers were held in stupor after being told that nutrition may have been undermined owing to the acceptance and distribution of milk formulas and infant formulas in the aftermath of the quake. The 7.2 quake has since left more than 2,000 aftershocks in Cebu and Bohol.

 Dr. Parolita Mission, National Nutrition Council 7 regional coordinator said, that the Milk Code of the Philippines specifically prohibits the donation of formula milk especially to infants and children during emergencies and disasters because use of formula milk increases the risk to death and disease. Will it help if the milk formulas were consumed by adults? The answer is still no.

In what appears to be a lapse in judgment, nutrition health workers said that they had accepted the donations thinking that the donors had meant good their intention to help the quake victims. Apparently because the health workers were themselves victims of the quake, they may have lapsed in discernment that there are many dangers in using milk formula during emergencies and disasters. But then in risk communication strategies, those involved in disaster management must themselves be psychologically and emotionally prepared to communicative healing and substantive messages. In this case where nutrition workers are themselves the victims, the ideal scenario was for external experts to have counseled the health workers first so they too are psychologically and emotionally prepared to communicate healing messages. External experts include those not directly involved as victims of the calamity.

Among the dangers in the use and consumption of milk during emergencies is that formula milk is not sterile. Using or consuming milk formula is unsafe when there is not enough clean water to sterilize feeding bottles and drinking utensils to prepare the formula. Water used may be contaminated and there may not be enough equipment, fuel, cooking pots and water to sterilize feeding bottles and drinking utensils.

Children and infants are especially vulnerable to diarrhea and infections owing to milk formulas because of incorrect proportion of formula milk with water which results to over or under diluted formula. Formula milk does not protect against infections.

Dr. Mission, who is also head of the Nutrition Cluster, underscored that breastfeeding should be protected even during emergencies and disasters.

Breast milk is still the best feeding for infants and children under two years old in hostile conditions and emergencies like earthquakes. By God's wondrous design, mother's breast milk have chemical nutrients that provide and protect infants and children under two years even in times of hardships, famine, emergencies or even when the mother is sick.

When a mother is exposed to infection, the baby will not suckle her sickness. What happens is that the body of the mother makes antibodies and her milk contains antibodies to protect the baby. Breasts do not produce sour or spoiled milk. Breast milk is always safe and will never get spoiled in the breast.

More than two weeks after the quake and after wave upon wave of relief goods have been distributed, it has become difficult to recall and pull out the distributed milk formulas. During discussions, the Nutrition Cluster pointed out that there may have been lapses in the centralization and regulation of donations coming in and when these are distributed. Nutrition health workers in Bohol are now assisting, supporting and counseling mothers to continue breastfeeding even during emergencies. There is ongoing rapid screening for acute malnutrition using mid-upper arm circumference measurements.

Meanwhile as dusk set on the tent homes in Barangay San Isidro, barking dogs and bleating goats could still be heard. And a still small voice of a baby cries and whimpers that life and saving lives must go on…even after lapses and breaches.